Gerdes T, Yates W R, Clancy G
Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Psychosomatics. 1995 Sep-Oct;36(5):480-6. doi: 10.1016/S0033-3182(95)71629-2.
The study's objective was to contrast the prevalence, phenomenology, and medical care utilization for panic disorder from 1980 to 1990. All psychiatric consultations from a university consultation service from the years 1980, 1985, and 1990 were located (N = 2,400). Patients meeting DSM-III-R panic disorder criteria were selected for chart review. Variations in demographics, comorbidity, prior medical evaluations, and referral patterns were analyzed. The prevalence rate for consultations meeting panic disorder criteria has increased (2.5% in 1980, 4.2% in 1985, and 5.1% in 1990; chi 2 = 7.5, P = 0.024). Referring physicians more frequently noted panic attacks in 1990 (5% in 1980, 21% in 1985, and 59% in 1990; chi 2 = 21.2, P = 0.0001). A summary measure of medical care utilization revealed no significant interval change. Panic disorder is being recognized and referred more frequently by medical physicians since the publication of DSM-III and DSM-III-R. However, delay of diagnosis and high medical care utilization remain significant problems.
该研究的目的是对比1980年至1990年惊恐障碍的患病率、症状学及医疗服务利用情况。找出了一所大学咨询服务机构1980年、1985年和1990年的所有精神科会诊记录（N = 2400）。选择符合《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）惊恐障碍标准的患者进行病历审查。分析了人口统计学、共病情况、既往医学评估及转诊模式的变化。符合惊恐障碍标准的会诊患病率有所上升（1980年为2.5%，1985年为4.2%，1990年为5.1%；卡方检验χ2 = 7.5，P = 0.024）。1990年转诊医生更频繁地注意到惊恐发作（1980年为5%，1985年为21%，1990年为59%；卡方检验χ2 = 21.2，P = 0.0001）。医疗服务利用的一项综合指标显示各时间段无显著变化。自《精神疾病诊断与统计手册》第三版（DSM-III）和《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）出版以来，内科医生对惊恐障碍的认识和转诊更为频繁。然而，诊断延迟和高医疗服务利用仍是重大问题。
